Summit on the High Cost of Health Insurance

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Summit on the High Cost of Health Insurance

• Commissioner Kim Holland
• Oklahoma Insurance Department

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Welcome to Summit III

• Summit I Identified problem areas and divided
  into task force groups
• Summit II Produced recommendations and actions
  to expand coverage and reduce costs
• Summit III Provide progress report on
  recommendations, update on Oklahomas health
  status and develop next steps

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2007 United Health Rankings
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2007 Commonwealth Fund Rankings
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2007 Commonwealth Fund Rankings
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Recommendation Themes

• Re-engineer healthcare system
• Promote health information technology
• Maximize federal dollars to expand existing
  programs
• Promote evidence-based
• approaches to treatment
• Cover our children

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Progress Report Recommendation 1

• Study innovative strategies for re-engineering
  healthcare coverage to expand access to care
  promote comprehensive benefit structure including
  benefits for wellness, primary care, critical
  care, mental health, dental and vision

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State Coverage Initiatives Grant

• One of 14 states selected to participate in the
  SCI program
• State teams will meet with experts from the
  Robert Wood Johnson Foundation to assess current
  challenges, analyze strategic policy options and
  refine current state-specific plans
• Development grants can be funded up to 200,000

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SCI Core Team

• Kim Holland
• Tom Adelson
• Doug Cox
• Brian Crain
• Mike Crutcher
• Mike Fogarty

• Melissa Gower
• Rodney Huey
• Murali Krishna
• Danny Morgan
• Susan Paddack
• Terri White

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SCI Team Vision

• All Oklahomans should have access to high quality
  health care and affordable health insurance
  through a private/public partnership in 3-5 years

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SCI Benchmarks

• We envision success when we have
• Witnessed sizeable reduction in the number of
  uninsured
• Made significant improvements in the rates of
  mortality
• Elevated above bottom quartile in all
  measurements included in Commonwealth Fund State
  Report Card

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SCI Areas of Emphasis

• Access
• Finance
• Quality/Performance
• Outreach

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Progress Report Recommendation 2

• Create and foster a reduced cost/core/basic
  healthcare benefit plan

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Choosing Healthplans All Together (OK CHAT)

• Builds consensus about a health coverage
  priorities with limited resources
• More than 40 sessions in 31 Oklahoma communities
• Six Town Hall discussions
• More than 400 citizens input gathered
• Cross-section of community
• Ran for six weeks August through October
• Information to Core Health Benefit Task Force

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OK CHAT Overview

• With limited resources, individuals choose
  healthcare benefits
• Individual data combined with group discussions
  involving negotiation, compromise and consensus
  building
• Results examine conflict between provider
  capabilities, consumer needs and employer
  affordability

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Comparison Groups

• Utilizing Round Three Consensus Data
• General
• Doctors
• Insurers
• Small Business

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Group Comparisons
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Group Comparisons

• Increase in Tier indicated desire to have more
  choice of access to hospitals

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Group Comparisons

• Increase in Tier would indicate a greater
  choice in selecting a primary care physician

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Group Comparisons

• Increase in Tier would give insured lower wait
  times and increased access via referral

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Group Comparisons

• Increase in Tier indicated desire for greater
  access to name brand prescription drugs

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Group Comparisons

• Increase in Tier indicated expansion of services
  to include (Tier 2) behavioral addictions and
  (Tier 3) long-term therapy

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Group Comparisons
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Group Comparisons
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Group Comparisons
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Group Comparisons
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Summit on the High Cost of Health Insurance

• Commissioner Kim Holland
• Oklahoma Insurance Department